Current challenges and next steps to combat acute respiratory distress syndrome in children

A new review of Pediatric Acute Respiratory Distress Syndrome (PARDS) highlights the lack of data available for standard treatment approaches and adjunctive therapies, leading to significant variability in patient management. This comprehensive review article, which also identifies a great need for studies to generate outcomes data in pediatric patients with ARDS, is published in Pediatric Allergy, Immunology, and Pulmonology, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers.

In "The Current State of Pediatric Acute Respiratory Distress Syndrome" coauthors Kirsten E. Orloff, MD, David A. Turner, MD, FCCM, FCCP, and Kyle J. Rehder, MD, FCCM, FCCP, Duke Children's Hospital, Durham, NC, present the physiologic basis of PARDS and describe the unique pediatric definition of the disorder and what puts a child at risk. The authors provide a thorough discussion of the current best practice strategies, including lung protective strategies as well as adjunctive options for these critically ill children. In the section entitled "Next Steps," they call for more high-quality data to support the effectiveness of potential treatments, studies that focus on pediatric patients with severe PARDS, and outcomes data in pediatric survivors of ARDS that would assess its effects on lung function, quality of life, and neurocognitive functioning.

Acute respiratory distress syndrome (ARDS) presents unique challenges in the pediatric age group and carries a mortality risk of approximately 24%. While this is both lower than the mortality risk for ARDS in adults and is decreasing over time in children, it continues to be a formidable problem. Accounting for up to 10% of all pediatric ICU admissions, PARDS confronts pediatric intensivists with the difficult task of identifying early signs of acute lung injury and selecting the best possible strategies for each individual child on a regular basis. This review provides a concise overview of best practice strategies to combat acute respiratory distress syndrome in children affected by this serious and potentially deadly condition."

Pediatric Allergy, Immunology, and Pulmonology Editor-in-Chief Mary Cataletto, MD, Professor of Clinical Pediatrics, Stony Brook University School of Medicine